Monday, March 29, 2010

Touch in the Midwifery Arts

Touch in the Midwifery ArtsThe midwife greets the mother and sits down in front of her. She lifts the mother’s dress and begins to firmly massage and palpate the abdomen. She assesses the position and health of the fetus, feels the lie of the uterus and aligns the energy flow through the abdomen. During the prenatal massage the mother and midwife talk about the expected baby, the woman’s health and her family. The midwife will perform a massage at every prenatal visit, during the birth and at postpartum visits. The mother’s mother may also massage her, as will her mother-in-law. The mother will then massage the new child. This dynamic web of touch has been played out all over the world, connecting midwives, mothers and massage, for thousands of years.

Before Western medical practices displaced traditional midwifery, the touch and massage of a midwife or birth attendant was a central component of prenatal care around the world. In the absence of obstetrical tools and gadgets, a midwife had her eyes, ears and hands to diagnose and assist pregnant women. Honed by constant practice, the midwife’s senses of observation and intuition were finely tuned. Today, traditional healers and midwives skillfully integrate the ancient healing arts of massage and midwifery, as they have for thousands of years.Prenatal massage and compassionate touch during the childbearing year are more than a primitive practice or luxurious pampering; they are an essential and vital part of holistic maternity care. The medical model of birth ignores and trivializes the therapeutic value of touch during pregnancy and childbirth. In the medical model, childbearing is analyzed from a pathological and intellectual perspective. Obstetrical and gynecological practices support the deprivation of human touch, pathologize the female body, increase childbearing morbidity and place women in a subservient role to the institution. However, pregnancy is not a pathological event or an intellectual construct; it is a healthy, primal and life-giving process. Compassionate touch of the mother during pregnancy and childbirth is essential for the development of maternal touching of the infant. Tactile stimulation of the newborn is necessary for healthy development and immunological resistance.Traditional midwives serve birth through their touch and intuition, holistic ways of learning that respect and nurture the ecology of birth. Interventions, questions and exams induce neocortical activity and the production of catecholamines (stress hormones) that interrupt the labor process. Intuitive touch and massage allows for midwife and mother to communicate without stimulating the neocortex and intervening in the natural rhythm of birth. Touch is the primal language of life; the language that speaks to the deep mind of a laboring woman and the awakening senses of an infant. Massage and healing touch enhance the body’s natural ability to sustain health and give birth. The integrity of midwifery care depends upon compassionate communication that respects the primal process of birth and women’s autonomy.